Abstract
Background
Intracranial arterial stenosis is a major cause of ischemic stroke in Asian populations. High-resolution magnetic resonance imaging (HR-MRI) of the vessel wall is an emerging tool that offers valuable insights.
Methods
We conducted a retrospective study of adult patients (≥18 years) with acute ischemic stroke and M1 MCA stenosis who underwent HR-MRI at the University Medical Center Ho Chi Minh City between January 2019 and May 2025.
Results
Sixty-two patients were included (mean age, 56 ± 13 years; male-to-female ratio, 2:1). The average stenosis degree was 66.3 ± 17.5, with severe stenosis in 38.7% of patients. The predominant pattern was eccentric stenosis (80.6%), more frequently observed in older patients. The mean remodeling index was 0.87 ± 0.21, and most cases showed negative remodeling. The majority of lesions at the stenotic site exhibited post-contrast enhancement, most commonly grade 2 enhancement (43.6%). The most frequent cause of stenosis was atherosclerosis (43 cases), followed by dissection (2 cases), Moyamoya disease (1 case), and indeterminate etiology (16 cases). Among infarct-associated atherosclerotic lesions, plaques with intraplaque hemorrhage (58.1%), irregular plaque surface (86.1%), and strong (grade 3) enhancement (46.5%) were observed more frequently than in the small non–infarct-associated incidental group; however, this exploratory comparison was limited by the very small size of the comparator group.
Conclusions
HR-MRI of the MCA vessel wall provides detailed information on stenotic lesion characteristics, aiding in the identification of the underlying etiology. These findings highlight the potential role of HR-MRI in stroke diagnosis and risk stratification in Vietnamese patients.
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